Segment 4 and the left lateral segment regeneration pattern after resection of the middle hepatic vein in a living donor right hepatectomy

Nir Lubezky, Irina Oyfe, Alan G. Contreras, Juan P. Rocca, Dianne Lapointe Rudow, Tara Keegan, Bashir Taouli, Leona Kim-Schluger, Sander Florman, Thomas Schiano, Marcelo Facciuto

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Inclusion of the middle hepatic vein (MHV) with a right hepatectomy (RH) in live donor liver transplantation improves venous drainage of the anterior sector of the graft. Its long-term effects on donor left liver (LL) regeneration are not well described. Methods Donors who underwent RH with MHV (MHV+, n = 12) were compared with donors who underwent RH with preservation of the MHV (MHV-, n = 24). Peri-operative complications and volume of the entire liver and individual segments were evaluated at 1 year post-donation. Results There was a trend towards a higher complication rate in the MHV+ group (41% versus 25%), without reaching statistical significance (P = 0.3). Males, high body mass index (BMI) and a smaller residual liver volume (RLV) were predictors for greater LL regeneration. MHV+ donors had impaired regeneration of segment 4 (S4) at 1 year, and compensatory greater left lateral segment regeneration. The absence of venous drainage of S4 (V4) to left hepatic vein (LHV) was a predictor of impaired S4 regeneration. Conclusions Regeneration of S4 is impaired in MHV+ donors. Caution should be taken when considering MHV removal on donors with dominant S4, especially on those with potential increased demand for liver regeneration, such as males, higher BMI and a smaller RLV.

Original languageEnglish (US)
Pages (from-to)72-78
Number of pages7
JournalHPB
Volume17
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Hepatic Veins
Living Donors
Hepatectomy
Regeneration
Tissue Donors
Liver Regeneration
Residual Volume
Drainage
Liver
Body Mass Index
Liver Transplantation
Transplants

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Segment 4 and the left lateral segment regeneration pattern after resection of the middle hepatic vein in a living donor right hepatectomy. / Lubezky, Nir; Oyfe, Irina; Contreras, Alan G.; Rocca, Juan P.; Rudow, Dianne Lapointe; Keegan, Tara; Taouli, Bashir; Kim-Schluger, Leona; Florman, Sander; Schiano, Thomas; Facciuto, Marcelo.

In: HPB, Vol. 17, No. 1, 01.01.2015, p. 72-78.

Research output: Contribution to journalArticle

Lubezky, N, Oyfe, I, Contreras, AG, Rocca, JP, Rudow, DL, Keegan, T, Taouli, B, Kim-Schluger, L, Florman, S, Schiano, T & Facciuto, M 2015, 'Segment 4 and the left lateral segment regeneration pattern after resection of the middle hepatic vein in a living donor right hepatectomy', HPB, vol. 17, no. 1, pp. 72-78. https://doi.org/10.1111/hpb.12303
Lubezky, Nir ; Oyfe, Irina ; Contreras, Alan G. ; Rocca, Juan P. ; Rudow, Dianne Lapointe ; Keegan, Tara ; Taouli, Bashir ; Kim-Schluger, Leona ; Florman, Sander ; Schiano, Thomas ; Facciuto, Marcelo. / Segment 4 and the left lateral segment regeneration pattern after resection of the middle hepatic vein in a living donor right hepatectomy. In: HPB. 2015 ; Vol. 17, No. 1. pp. 72-78.
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AU - Rudow, Dianne Lapointe

AU - Keegan, Tara

AU - Taouli, Bashir

AU - Kim-Schluger, Leona

AU - Florman, Sander

AU - Schiano, Thomas

AU - Facciuto, Marcelo

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N2 - Background Inclusion of the middle hepatic vein (MHV) with a right hepatectomy (RH) in live donor liver transplantation improves venous drainage of the anterior sector of the graft. Its long-term effects on donor left liver (LL) regeneration are not well described. Methods Donors who underwent RH with MHV (MHV+, n = 12) were compared with donors who underwent RH with preservation of the MHV (MHV-, n = 24). Peri-operative complications and volume of the entire liver and individual segments were evaluated at 1 year post-donation. Results There was a trend towards a higher complication rate in the MHV+ group (41% versus 25%), without reaching statistical significance (P = 0.3). Males, high body mass index (BMI) and a smaller residual liver volume (RLV) were predictors for greater LL regeneration. MHV+ donors had impaired regeneration of segment 4 (S4) at 1 year, and compensatory greater left lateral segment regeneration. The absence of venous drainage of S4 (V4) to left hepatic vein (LHV) was a predictor of impaired S4 regeneration. Conclusions Regeneration of S4 is impaired in MHV+ donors. Caution should be taken when considering MHV removal on donors with dominant S4, especially on those with potential increased demand for liver regeneration, such as males, higher BMI and a smaller RLV.

AB - Background Inclusion of the middle hepatic vein (MHV) with a right hepatectomy (RH) in live donor liver transplantation improves venous drainage of the anterior sector of the graft. Its long-term effects on donor left liver (LL) regeneration are not well described. Methods Donors who underwent RH with MHV (MHV+, n = 12) were compared with donors who underwent RH with preservation of the MHV (MHV-, n = 24). Peri-operative complications and volume of the entire liver and individual segments were evaluated at 1 year post-donation. Results There was a trend towards a higher complication rate in the MHV+ group (41% versus 25%), without reaching statistical significance (P = 0.3). Males, high body mass index (BMI) and a smaller residual liver volume (RLV) were predictors for greater LL regeneration. MHV+ donors had impaired regeneration of segment 4 (S4) at 1 year, and compensatory greater left lateral segment regeneration. The absence of venous drainage of S4 (V4) to left hepatic vein (LHV) was a predictor of impaired S4 regeneration. Conclusions Regeneration of S4 is impaired in MHV+ donors. Caution should be taken when considering MHV removal on donors with dominant S4, especially on those with potential increased demand for liver regeneration, such as males, higher BMI and a smaller RLV.

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